Provider Demographics
NPI:1861928244
Name:SCHNURBUSCH, GINA MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:SCHNURBUSCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4003
Mailing Address - Country:US
Mailing Address - Phone:314-220-2455
Mailing Address - Fax:
Practice Address - Street 1:5551 WINGHAVEN BLVD STE 290
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-3629
Practice Address - Country:US
Practice Address - Phone:636-695-2575
Practice Address - Fax:314-590-5938
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016004339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily